<div class=grid_18>
<div class=grid_10> 
    <div class=block-border> 
        <div class=block-header> 
            <h1>Enter Midweek Prayer</h1><span></span> 
        </div> 

        <form id=validate-form class="block-content form" action="add" method=post>
                      
            <div class=_50> 
                <p><label for=textarea>Quarter</label> 
                    <input id="mwpqtr" name="mwpqtr" class="required" class="input-xlarge" type="text" value=""/></p> 
            </div>  
                
            <div class=_50> 
                <p><label for=year>Year</label>
                    <input id="buzmdate" name="buzmdate" class="required" type="year" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=datepicker>Date</label>
                    <input id="mwpdate" name="mwpdate" class="required" type="date" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Prayer</label>
                    <input id="prayer" name="prayer" class="" type="text" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Leader</label>
                    <input id="leader" name="leader" class="required" type="text" value=""/></p> 
            </div>

            <div class=_50> 
                <p><label for=textarea>Hymns</label>
                    <input id="hymns" name="hymns" class="" type="text" value=""/></p> 
            </div>
            
            <div class=block-actions> 
                <ul class=actions-left> 
                    <li><a class="button red" id=reset-validate-form href="javascript:void(0);">Reset</a></li> 
                </ul> 

                <ul class=actions-right> 
                    <li><input type=submit id="Save-Board Actions" class="button" value="Save Record"></li> 
                </ul> 
            </div> 
        </form> 
    </div> 
</div> 